Early vascular healing after titanium–nitride–oxide-coated stent versus platinum–chromium everolimus-eluting stent implantation in patients with acute coronary syndrome

Varho, Ville; Kiviniemi, Tuomas; Nammas, Wail; Sia, Jussi; Romppanen, Hannu; Pietilä, Mikko; Airaksinen, Juhani; Mikkelsson, Jussi; Tuomainen, Petri; Perälä, Anssi; Karjalainen, Pasi P.

doi:10.1007/s10554-016-0871-7

Cited by 15 publications

(8 citation statements)

References 38 publications

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“…However, it should be noted that the O-ZES was implanted in a higher proportion of unstable patients as compared to the R-ZES study group (~85% vs. ~30%). It was higher than that observed at 2-month follow-up for the durable polymer platinum chromium everolimus-eluting stent (~82%) [23], and CD34 sirolimus-eluting coronary stent (~85%) (COMBO stent, OrbusNeich, China) and for an open cell stent (Angiolite, iVascluar, Spain) at 3-month follow-up (86%) [24, 25].…”

Section: Discussionmentioning

confidence: 95%

Short-term stent coverage of second-generation zotarolimus-eluting durable polymer stents: Onyx one-month optical coherence tomography study

Roleder¹,

Kedhi

Berta

et al. 2019

pwki

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Introduction To date the early strut coverage with the second-generation durable-polymer ONYX zotarolimus-eluting stent (O-ZES) is unknown. Aim Optical coherence tomography (OCT) assessed the strut coverage of O-ZES at thirty-day follow-up. Material and methods OCT was performed after implantation and at 1-month follow-up in 15 patients treated with O-ZES. Results Mean patient age was 67 ±7 years (73% males). The clinical presentation consisted of acute coronary syndromes ( n = 13) and stable coronary disease ( n = 2). Four (26%) patients had diabetes. OCT analysis was performed at baseline and 1-month follow-up in all stents. 378 cross-sections with 3582 struts were assessed at baseline and 3661 at follow-up. At follow-up, 88% struts were covered by tissue with a median thickness 37.91 μm (IQR: 22.32–64.15). Median in-stent area obstruction by neointima was 2.64% (IQR: 1.70–4.84). From the total stent covered area, 92.3% showed complete strut coverage. Homogeneous tissue was observed in 74% of cases. There were no differences in minimal lumen area (5.07 ±1.08 mm 2 vs. 4.81 ±0.94 mm 2 , p = 0.125) or minimal stent area (4.95 ±1.22 mm 2 vs. 4.92 ±0.99 mm 2 ) at baseline and at follow-up. There were no differences in the rate of strut malapposition (4.3% vs. 5.7%, p = 0.417). For all stents, malapposition volume was 47.9 mm 3 at baseline and 51.7 mm 3 at follow-up, giving the late acquired stent malapposition volume of 3.8 mm 3 . Conclusions The second-generation durable polymer O-ZES showed favorable vessel healing at 30-day OCT follow-up.

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Section: Discussionmentioning

confidence: 95%

Short-term stent coverage of second-generation zotarolimus-eluting durable polymer stents: Onyx one-month optical coherence tomography study

Roleder¹,

Kedhi

Berta

et al. 2019

pwki

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“…Neointimal strut coverage is greatly accelerated in the absence of antiproliferative drugs. Human OCT studies have shown high degrees of stent coverage as early as 4–8 weeks following stent implantation 11–14. We chose this early time point (3 weeks) so that we could unveil potential differences in the healing response before complete surface coverage would occur.…”

Section: Methodsmentioning

confidence: 99%

Biological effect of microengineered grooved stents on strut healing: a randomised OCT-based comparative study in humans

et al. 2017

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ObjectiveTo evaluate the biological effect of microengineered stent grooves (MSG) on early strut healing in humans by performing optical coherence tomography (OCT) analysis 3 weeks following the implantation.BackgroundIn the experimental setting, MSG accelerate endothelial cell migration and reduce neointimal proliferation compared with bare metal stent (BMS).MethodsA total of 37 patients undergoing percutaneous coronary intervention with de novo coronary lesions were randomly assigned to either MSG (n=19) or an identical BMS controls (n=18). All patients underwent OCT imaging at 3 weeks. A total of 7959 struts were included in the final analysis.ResultsAt 3 weeks following stent implantation, almost all struts analysed (~97%) had evidence of tissue coverage. The percentage of partially covered struts was comparable between both groups. However, the percentage of fully embedded struts was higher in the BMS group (81.22%, 49.75–95.52) compared with the MSG group (74.21%, 58.85–86.38). The stent-level analysis demonstrated reduction in neointimal formation (neointimal hyperplasia area and volume reduction of ~14% and ~19%, respectively) in the MSG versus the BMS group. In the strut-level analysis, an even greater reduction (~22% in neointimal thickness) was seen in the MSG group. Layered neointimal was present in ~6% of the OCT frames in the BMS group while it was not present in the MSG group.ConclusionsMSG induced a more homogeneous and predictable pattern of surface healing in the early stages following stent implantation. The biological effect of MSG on stent healing has the potential to improve the safety profile of current generation drug-eluting stents.ClassificationsBMS, OCT, clinical trials.

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“…Note: Ineligible records are listed with the references [ 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 ,…”

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Efficacy and Safety of TiNO-Coated Stents versus Drug-Eluting Stents in Acute Coronary Syndrome: Systematic Literature Review and Meta-Analysis

et al. 2022

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(1) Background: Practice guidelines define drug-eluting stents (DES) as the standard of care in coronary percutaneous coronary intervention (PCI), including in acute coronary syndrome (ACS). This is based on comparisons with bare-metal stents (BMS). However, non-drug-eluting titanium-nitride-oxide-coated stents (TiNOS) have not been taken into account. The objective of this study is to determine whether TiNOS can be used as an alternative to DES in ACS. (2) Methods: A prospective systematic literature review (SLR), conducted according to the PRISMA guidelines, was performed, wherein multiple literature databases from 2018 and 2022 were searched. Prospective, randomised, controlled trials comparing outcomes after PCI with TiNOS vs DES in any coronary artery disease (CAD) were searched. Clinical outcomes were meta-analytic pooled risk ratios (RR) of device-oriented Major Adverse Cardiac Events (MACE) and their components. The analysis stratified outcomes reported with ACS-only vs ACS jointly with chronic coronary syndrome (CCS). (3) Results: Five RCTs were eligible, comprising 1855 patients with TiNOS vs 1363 with DES at a 1-year follow-up. Three enrolled patients presented with ACS only and two with ACS or CCS. The latter accounted for most of the patients. The one-year pooled RRs in those three RCTs were as follows: MACE 0.93 [0.72, 1.20], recurrent myocardial infarction (MI) 0.48 [0.31, 0.73], cardiac death (CD) 0.66 [0.33, 1.31], clinically driven target lesion revascularization (TLR) 1.55 [1.10, 2.19], and stent thrombosis (ST) 0.35 [0.20, 0.64]. Those results were robust to a sensitivity analysis. The evidence certainty was high in MACE and moderate or low in the other endpoints. (4) Conclusions: TiNOS are a non-inferior and safe alternative to DES in patients with ACS.

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Early vascular healing after titanium–nitride–oxide-coated stent versus platinum–chromium everolimus-eluting stent implantation in patients with acute coronary syndrome

Cited by 15 publications

References 38 publications

Short-term stent coverage of second-generation zotarolimus-eluting durable polymer stents: Onyx one-month optical coherence tomography study

Short-term stent coverage of second-generation zotarolimus-eluting durable polymer stents: Onyx one-month optical coherence tomography study

Biological effect of microengineered grooved stents on strut healing: a randomised OCT-based comparative study in humans

Efficacy and Safety of TiNO-Coated Stents versus Drug-Eluting Stents in Acute Coronary Syndrome: Systematic Literature Review and Meta-Analysis

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